Transporting Dirty Surgical Instruments

When transporting dirty surgical instruments from the point of use to the sterile processing area, there are several important considerations to ensure safety and effective handling. These considerations apply to any surgical instruments used within the facility, as well as those being transported from outside clinics or entities that use the Central Sterile Processing department for cleaning and sterilization. Here are five key things to keep in mind:

1. Containment and Segregation: It is crucial to contain and segregate dirty surgical instruments to prevent cross-contamination. Use dedicated containers or rigid trays specifically designed for transporting soiled instruments. Ensure that each instrument is properly placed and secured within the container to prevent damage and maintain the integrity of the instruments. Many trays come with modified internal containers that secure instruments such as a Synthes Large Fragment system. Returning surgical instruments to their specified trays helps ensure those instruments are not lost during transport and cleaning, and makes the process more efficient to get those trays back to use.
2. Leakage Prevention: To avoid any leakage of blood, bodily fluids, or other contaminants during transportation, ensure that the containers used are leak-proof and properly sealed. This prevents the spread of pathogens and minimizes exposure risks to healthcare workers. If transporting in case carts, the doors must be closed. Many newer case carts are built with slight tilts in the shelving and floors of the inner case cart to collect any fluid that may drip from the trays. 
3. Identification and Documentation: Clearly label and identify the containers or trays containing the dirty instruments with appropriate tags or labels. Include necessary information such as the date, time, and location of collection, as well as any relevant patient or procedure details. Accurate documentation helps in tracking the instruments, maintaining accountability, and facilitating proper processing.
4. Safe Handling and Ergonomics: When transporting dirty instruments, prioritize the safety and well-being of healthcare workers. Ensure that they have access to personal protective equipment (PPE) such as gloves and possibly protective eyewear, as needed. Promote proper lifting and ergonomics techniques to prevent injuries during the handling and transportation process.
5. Prompt Transport: Timely transport of dirty instruments to the sterile processing area is essential to minimize the risk of contamination and maintain the integrity of the instruments. Establish clear protocols and procedures for pre-treating dirty surgical instruments and transporting those dirty instruments, ensuring that dedicated personnel are responsible for this task. Failure to maintain appropriate moisture on dirty instruments may cause bioburden to dry and harden making the cleaning process timely and unnecessary. Using sterile water to soak a towel and lay over the dirty instruments, or a pre-enzymatic gel or foam will keep the instruments moist, and begin the breakdown process of blood and bioburden. Avoid unnecessary delays and promptly deliver the instruments to the designated processing area.

It is important to note that these recommendations should be considered in conjunction with any local or facility-specific guidelines and regulations. Adhering to proper protocols for transportation helps maintain the safety of healthcare workers, preserves the quality of the instruments, and ensures the effective processing and sterilization of surgical instruments for subsequent use. If any of the above considerations are not being followed in your facility, consider bringing this information back to your leadership for discussion to see if it would be beneficial for your department.